Measles yog ib qho mob hnyav, kis tau tus kab mob loj heev uas tshwm sim hauv cov menyuam yaus. Anthroponotic kab mob yog tus yam ntxwv ua npaws, maculopapular ua pob liab vog thoob plaws lub cev, conjunctival hyperemia, thiab o ntawm lub sab sauv ib ntsuj av. Raws li tus kab mob no accumulates nyob rau hauv lub hlwb ntawm lub reticuloendothelial system, cov tsos mob ntawm qhua pias nyob rau hauv ib tug me nyuam nce. Tsis ntev tom qab kev kis kab mob los yog kev qhia txog cov tshuaj tiv thaiv nyob, kev tsim cov tshuaj tiv thaiv tau tsim tawm uas yuav nthuav dav hauv cov ntshav plasma rau ntau xyoo lawm. Yog li ntawd, tus kab mob kis mus rau tom qab kev tiv thaiv ib puag ncig ruaj khov.
Pathogenesis
Tus kab mob ua rau mob qhua pias, uas yog tus kab mob loj (120-250 nm inch) spherical RNA tus kab mob, tsis muaj cov enzyme neuraminidase, uas txawv nws ntawm lwm cov tswv cuab ntawm tsev neeg paramyxovirus. Cov kab mob tshwm sim los ntawm cov kab mob hauv huab cuaTus kab mob qhua pias yog tus neeg mob. Thaum hnoos, txham lossis hais lus, cov kab mob nkag mus rau sab nraud ib puag ncig, tom qab ntawd qhov kev ncua zoo nrog cov kwj deg yog nqa mus rau qhov deb heev.
Thaum xub thawj, tus kab mob no kis tau rau hauv submucosa thiab cov qog ntshav hauv cheeb tsam, thaum kawg nkag mus rau hauv tus menyuam cov hlab ntsha. Thawj cov tsos mob ntawm qhua pias nyob rau hauv cov me nyuam tshwm 1-2 lub lis piam tom qab kis kab mob (lub sij hawm incubation). Hauv kev teb rau cov lus qhia ntawm tus neeg sawv cev txawv teb chaws, chav kawm M immunoglobulins ("cov tshuaj tiv thaiv kev ntxhov siab") raug tsim, thiab tsuas yog tom qab 5 hnub cov synthesis ntawm IgG pib, uas tiv thaiv cov menyuam yaus los ntawm kev rov ua dua tshiab.
Kev sib kis index
Measles yog nyob rau hauv qeb ntawm "nruab nrab" kev kis tus menyuam yaus uas muaj kev sib kis loj (98%). Tus kab mob no xis nyob hauv qhov cua tsis zoo, chav da dej, yooj yim txav los ntawm pem teb sab saum toj mus rau hauv qab los ntawm cov ntaiv, txoj hauv kev thiab txawm tias qhov cua nkag. Yog li, txhua tus neeg nyob hauv tib lub tsev nrog tus menyuam muaj mob, tab sis kuj cov neeg nyob ze ntawm qhov nkag nkag mus rau hauv thaj chaw tiv tauj.
Kev kuaj mob nta
Tus kws kho mob uas tsis muaj kev paub tuaj yeem yooj yim nkag siab cov tsos mob ntawm tus mob qhua pias hauv cov menyuam yaus uas muaj tus kab mob ua pa. Kev tshawb fawb serological (RSK, RTGA, RIF) thiab enzyme immunoassay txoj kev siv los lees paub lossis tsis lees paub qhov muaj tus kab mob hauv lub cev. Thaum kuaj lub cev ntawm tus menyuam, tus kws kho mob sau ntawv o thiab o ntawm daim tawv muag, puffiness ntawm lub ntsej muag, ntxhib qhov ncauj mucosa.nrog dawb me ntsis opposite cov molars me.
Hauv kev tshuaj ntsuam dav dav ntawm cov ntshav nrog tus kab mob qhua pias, muaj qhov txo qis hauv qib lymphocytes, eosinophils, nce ESR tiv thaiv keeb kwm yav dhau ntawm leukocytopenia nruab nrab, nrog rau plasmacytosis. Yog tias koj xav tias kev txhim kho ntawm kev mob ntsws, koj tsis tuaj yeem ua yam tsis muaj x-ray ntawm lub ntsws. Txhawm rau paub qhov txawv ntawm cov kab mob ua pa nyuaj lossis ua xua los ntawm cov tsos mob ntawm tus mob qhua pias hauv cov menyuam yaus thiab xaiv cov kev kho mob uas tsim nyog, siv cov kev kuaj mob sib txawv. Kev ua xua feem ntau yog nrog khaus ntawm daim tawv nqaij, tab sis nws tsis yog tus cwj pwm los ntawm kev mob hnyav ntawm lub cev thiab qhov tsos ntawm enanthema.
Measles in me nyuam: cov tsos mob ntawm tus kab mob
Daim duab kho mob ntawm qhua pias yog tus cwj pwm los ntawm kev ua tiav ntawm lub sijhawm ntawm tus kab mob - incubation, catarrh, ua pob liab vog thiab pigmentation (reconvalescence). Lub sij hawm latent kav li ntawm 7-14 hnub, nyob rau hauv cov ntaub ntawv ntawm kev taw qhia ntawm immunoglobulin nyob rau hauv ua ntej ntawm tus kab mob, tus kab mob tsis tshwm sim nyob rau hauv txhua txoj kev rau 3-4 lub lis piam. Tus me nyuam tuaj yeem "sib qhia" tus kab mob no rau lwm tus tsuas yog ob hnub kawg ntawm theem pib thiab mus txog hnub 4 ntawm cov pob liab liab.
Lub sijhawm catarrhal lossis prodromal ntawm tus mob qhua pias yog tshwm sim los ntawm cov tsos mob "zoo li mob khaub thuas":
- Patological tsis muaj zog.
- remny lossis txhaws ntswg.
- Khaub, "puag" hnoos.
- Redness thiab o ntawm daim tawv muag, conjunctivitis.
- nce hauv lub cev kub txog 38-40 ° C.
- Ntaus, chim plab.
- Measles enanthem (patchy hyperemia ntawm lub siab mos thiab tawv palate).
Tsis ntev, cov mucous ntawm lub puab tsaig nyob rau hauv thaj tsam ntawm ob lub puab tsaig qis yog npog nrog cov xim dawb nrog rau cov ciam teb liab liab nyob ib ncig ntawm lub periphery. Filatov-Koplik-Belsky me ntsis yog lub ntsiab pathognomonic kos npe rau ntawm qhua pias. Greyish-dawb dots qhov loj ntawm cov noob poppy (1-2 mm inch) tshwm sim los ntawm kev puas tsuaj thiab desquamation ntawm cov hlwb epithelial. Nyob rau tib lub sij hawm, tus me nyuam ua lethargic, yws ntawm mob taub hau thiab tsaug zog, tas li squints, tus nplaig yog lined. Cov menyuam mos yog qhov tsis zoo, lawv txoj kev qab los noj mov tsis zoo lossis tsis tuaj yeem ua tiav, qee zaum muaj photophobia thiab nce lacrimation. Cov tsos mob ntawm qhua pias nyob rau hauv cov me nyuam txhaj tshuaj (ib hom kab mob atypical) yog tsawg, cov tsos mob ntawm intoxication ntawm lub cev yog me me.
Tom qab 3-4 hnub, lub catarrhal theem ntawm tus kab mob yog hloov los ntawm ib lub sij hawm ntawm pob khaus. Thaum xub thawj, cov pob liab liab yog nyob rau ntawm lub ntsej muag, nraub qaum ntawm lub taub hau, hauv qab cov plaub hau, tom qab ntawd kis mus rau lub cev, sab sauv thiab sab qis ntawm tus menyuam. Liab-burgundy papules tsis zoo nyob rau hauv cov duab thiab me ntsis nce saum npoo ntawm daim tawv nqaij, nyob rau hauv qhov chaw lawv sib koom ua ke, tsim ib cheeb tsam ntawm redness. Pib txij hnub 4th ntawm cov pob liab liab, cov tsos mob ntawm tus mob qhua pias hauv cov menyuam yaus (ua pob ua npaws, ua npaws, hnoos, photophobia, thiab lwm yam) ploj mus, qab los noj mov, pw tsaug zog thiab lub siab lub ntsws ntawm tus menyuam normalizes. Pigmentation kav ntev dua 1-1.5 lub lis piam, cov ntsiab lus ntawm pob khaus regress nyob rau hauv tib qhov kev txiav txim ntawm tsos.
Txoj Kev Tshuaj Kho Mob
Vim qhua pias yog kab mob kis, tsis muaj tshuaj tshwj xeeb rau nws txoj kev kho. Cov tshuaj tua kab mob tsuas yog qhia thaum muaj mob ntsws lossis lwm yam kab mob. Nws yuav tsis tuaj yeem tshem tawm cov tsos mob ntawm tus mob qhua pias hauv cov menyuam yaus thaum pib ntawm tus kab mob, vim tias immunoglobulins tseem tsis tau tsim. Cov tsos mob muaj xws li pw tsaug zog, haus dej kom ntau, noj mucolytics thiab tshuaj tua kab mob.
Tiv thaiv kom lub cev qhuav dej thaum kub taub hau lossis ntuav yuav pab npaj cov tshuaj "Regidron", "Humana Electrolyte". Cov niam txiv tuaj yeem npaj cov tshuaj zoo sib xws ntawm lawv tus kheej: yaj 1 tbsp hauv ib liter dej kub. ib diav suab thaj thiab ½ tsp. ci dej qab zib. Cov tsos mob thiab cov tsos mob ntawm qhua pias nyob rau hauv cov me nyuam feem ntau nrog apathy, tsis muaj qab los noj mov, tus kab mob no ua rau lub cev tsis muaj zog, yog li provoking kev loj hlob ntawm opportunistic microflora. Multivitamin complexes "Pikovit", "Alfavit", Multi-tabs, "Vitrum Junior", thiab lwm yam ua rau cov tsis muaj vitamins, micro- thiab macroelements nyob rau hauv tus me nyuam lub cev.
Nrog conjunctivitis, qhov muag raug ntxuav nrog 2% tov ntawm boric acid, furacilin. "Sulfacyl Sodium", "Suprastin", "Diazolin", "Clemastin", "Tavegil" thiab lwm yam tshuaj tiv thaiv kab mob tau raug sau tseg rau kev mob hnyav ntawm lub cev, edema, hyperemia ntawm pharynx thiab tawv nqaij. Cov tshuaj uas tsis yog-steroidal anti-inflammatory tsis tsuas yog txo qhov kub thiab txias, tab sis kuj pab tiv nrog mob taub hau, mob hauv caj pas. Qhov ntau npaum ntawm cov tshuaj raws li paracetamol lossis ibuprofen nyob ntawm hnub nyoog thiab qhov hnyavtus menyuam. Kev tawm tsam ntawm hnoos qhuav yog nres nrog cov ntsiav tshuaj "Ambroxol", "Haliksol", rau qhov tsawg tshaj plaws, cov kua txiv hmab txiv ntoo "Lazolvan" yog haum. Tso cai xaiv cov kev kho mob rau cov tsos mob ntawm qhua pias nyob rau hauv cov me nyuam mus rau ib tug kws kho mob tshwj xeeb.
Txhawm rau tiv nrog qhov mob hnoos nrog qhua pias, cov tshuaj ntawm cov hauv paus licorice lossis marshmallow yuav pab tau. Raws li ib tug expectorant, infusions ntawm coltsfoot nplooj, thyme, calendula paj thiab chamomile kuj siv. Elderberries, decoctions ntawm elecampane, lungwort muaj diaphoretic thiab anti-inflammatory zog, ntxiv dag zog rau lub cev.
Qee cov lus qhia muaj txiaj ntsig kom ua kom koj rov zoo:
- nyob rau hauv kev txiav txim rau cov pob xoo hluav taws los ntawm cov mucous membrane, tus menyuam yuav tsum yaug nws lub qhov ncauj lossis sage txhua 2 teev (1 tbsp. Nyom nyob rau hauv lub khob ntawm boiling dej).
- Ua kom khaus khaus thiab tshem tawm ntawm daim tawv nqaij nrog mob qhua pias sov da dej nrog ntxiv ntawm bran. Nco ntsoov tias lub sijhawm ntawm cov txheej txheem dej tsis pub dhau 10 feeb. Qhov kub zoo rau kev ua luam dej yog 34-35 ° C
- Linden tshuaj yej muaj tshuaj tua kab mob thiab sedative nyhuv ntawm tus menyuam lub cev. Txhawm rau npaj nws, koj xav tau 5 tbsp. l. qhuav linden paj, ib liter dej. Ncuav dej npau npau tshaj cov khoom siv raw, kaw lub hau kom nruj thiab qhwv lub lauj kaub nrog phuam. Tom qab 30-40 feeb, tus neeg sawv cev kho tau npaj rau kev siv. Ib 150-200 ml haus ua ntej yuav mus pw alleviates thawj cov tsos mob ntawm qhua pias nyob rau hauv cov me nyuam.
Kev noj haus thiab haus dej haus
Tus kab mob qhua pias no loj heevcuam tshuam rau vitamin C thiab retinol (vitamin A), yog li teeb meem nrog lub qhov muag, cov pos hniav mucosa, qhov ncauj kab noj hniav, sab sauv kab noj hniav. Ascorbic acid, nrog rau retinol, txhawb kev tsim cov tshuaj tiv thaiv kab mob, txhawb kev ua haujlwm ntawm phagocytic ntawm leukocytes, yog li ua rau tus menyuam muaj peev xwm tiv thaiv kab mob.
Ua tib zoo saib xyuas kev noj haus thiab haus dej ntawm koj tus menyuam. Cov zaub mov yuav tsum muaj calorie ntau ntau, tab sis yooj yim digestible, kom lub cev mob siab rau tag nrho nws lub zog tsis txhob zom nws, tab sis mus tua kab mob. Thaum kub siab, tsis txhob overload lub plab zom mov nrog cov zaub mov hnyav, lo rau cov khoom noj uas tsis muaj mis nyuj thiab zaub thiab txiv hmab txiv ntoo. Muab qhov nyiam rau ntses chav cutlets, zaub stewed, mis nyuj hauv nws daim ntawv ntuj, nrog rau tsev cheese, kefir thiab yogurts hauv tsev. Sourdough "Narine" yog ib qho zoo heev detoxifier rau kab mob qhua pias.
Nutritionists pom zoo kom tshem tawm ntawm cov zaub mov:
- Fried foods and tsiaj fats (lard, cooking oil).
- -cov nqaij haus, marinades.
- khoom noj yooj yim thiab yoo mov.
- txuj lom (horseradish, mustard, kua txob kub).
- Cov khoom noj uas muaj kev ua xua: strawberries, melons, qe qaib, dej qab zib, citrus txiv hmab txiv ntoo thiab lwm yam txiv hmab txiv ntoo txawv, txiv ntoo (peanuts, hazelnuts).
Lub ntim ntawm cov kua yog nyob ntawm lub hnub nyoog ntawm tus menyuam thiab yog 1.5-2.5 litres ntawm cov dej huv, tsis muaj carbonated ib hnub twg. Cov txiv hmab txiv ntoo uas tsis yog acidic, qab zib tshuaj yej nrog txiv qaub, kissels, compotes, freshly squeezed txiv hmab txiv ntoo thiab zaub kua txiv yog zoo suited. Nrog rau lub subence ntawm catarrhal phenomena nyob rau hauvKev noj zaub mov yog qhia cov mis nyuj porridge (nqaij, buckwheat, millet), zaub mov noj, ci txiv hmab txiv ntoo, zaub zaub xam lav, nplooj spinach, dill lossis parsley. Nws yog ib advisable mus ua noj thawj cov kev kawm nyob rau hauv tsawg-rog nqaij broth. Thaum koj tus menyuam cov tsos mob qhua pias ploj lawm, koj tuaj yeem rov qab mus rau koj qhov kev noj haus zoo li qub.
tshuaj tiv thaiv kab mob qhua pias
Cov tshuaj tiv thaiv kab mob qhua pias muaj tus kab mob Atenuated (kuaj tsis muaj zog) RNA, uas tsis tuaj yeem ua tus kab mob ntawm nws tus kheej, tab sis tsuas yog "paub" tus menyuam lub cev nrog tus mob qhua pias. Kev taw qhia txog cov khoom siv antigenic pab tsim kom muaj kev tiv thaiv kab mob nco, yog li tiv thaiv thawj lossis rov kis tus menyuam. Ib txoj hauv kev zoo sib xws ntawm kev ua haujlwm muaj peb yam tshuaj tiv thaiv kab mob qhua pias, rubella thiab mumps (MMR).
Thaum 12 lub hlis, thawj zaug txhaj tshuaj tiv thaiv, kev npaj kho dua tshiab tau ua tiav thaum muaj hnub nyoog rau xyoo. Yog tias vim qee qhov kev tiv thaiv kev tiv thaiv tsis tau tsim, kev kuaj mob ntawm tus mob qhua pias hauv tus menyuam yuav tsis yooj yim. Kwv yees li 5-10% ntawm cov menyuam yaus tom qab txhaj tshuaj tiv thaiv tau poob mob nrog rau tus mob qhua pias, uas yog tus cwj pwm los ntawm kev ncua sij hawm incubation thiab cov duab tshem tawm. Ib hom mob me ntawm tus kab mob no tau ntsib los ntawm cov menyuam yug tshiab thiab cov menyuam mos uas tsis tau poob cov tshuaj tiv thaiv kab mob qhua pias kis tau los ntawm leej niam, nrog rau cov uas tau txais kev siv tshuaj tiv thaiv (xws li tshuaj tiv thaiv) lossis kev txhaj tshuaj tiv thaiv kab mob (immunoglobulin).
Kev Tiv Thaiv
Tus kab mob qhua pias yog kis tau thiab rov muaj dua txhua 2-4 xyoos. Cov niam txiv hauvNws yog ib qho tseem ceeb kom paub yuav ua li cas cov tsos mob ntawm qhua pias tshwm sim nyob rau hauv cov me nyuam, qhov no yuav pab kom paub txog ib tug txaus ntshai kab mob nyob rau hauv lub sij hawm thiab tiv thaiv kev loj hlob ntawm cov teeb meem ntawm lub neej. Ua raws li cov cai ntawm kev saib xyuas tus kheej (sib cais tais diav, phuam so tes, khoom ua si, thiab lwm yam). Tus me nyuam yuav tsum tau haus dej kom ntau li ntau tau, nws yog qhov tsim nyog kom haus dej sov. Ua kom koj cov zaub mov muaj zog nrog cov zaub mov muaj zog, cov zaub mov npaj yuav tsum tsis txhob ua rau mob plab hnyuv mucosa.
Thaum mob qhua pias, qhov chaw tsis muaj tshuaj tua kab mob. Chav tsev kub thiab hluav taws xob ultraviolet muaj qhov cuam tshuam rau tus kab mob, tom qab 2-3 teev nws poob tag nrho nws cov kab mob. Yog tias pom cov tsos mob ntawm tus mob qhua pias nyob rau hauv tus me nyuam, cov ntaub ntawv hais txog tus neeg mob thiab cov neeg uas tau ntsib nrog nws yuav raug xa mus rau cov tsev kawm ntawv tsim nyog rau menyuam yaus. Cov kws tshaj lij tawm tswv yim los tswj tus mob qhua pias immunoglobulin hauv 5 hnub txij li lub sijhawm sib cuag.
Muaj Teeb Meem
Muaj kev ntseeg yuam kev tias mob qhua pias yog ib yam kab mob tsis muaj mob uas kho tau zoo tshaj plaws thaum ntxov. Qhov tseeb, kev kis kab mob hnyav ua rau muaj kev cuam tshuam ntawm kev ua pa, nruab nrab thiab peripheral paj hlwb, plab hnyuv (colitis, enterocolitis). Cov menyuam yaus hnub nyoog qis dua 2 xyoos tuaj yeem kis mob qhua pias multicellular pneumonia, thaum lub sijhawm pigmentation, fibrous-necrotic lossis ulcerative stomatitis, laryngitis, laryngotracheitis tshwm sim. Kev puas tsuaj rau lub hauv nruab nrab lub paj hlwb yog fraught nrog o ntawm daim nyias nyias ntawm lub hlwb thiab / los yog tus txha caj qaum, kev loj hlob ntawm sclerosing panencephalitis thiab meningoencephalitis. Thaum muaj mob hnyavteeb meem, tus me nyuam xav tau kev kho mob hauv tsev kho mob, kev teem caij tshuaj tua kab mob. Nyob rau hauv cov xwm txheej hnyav, kev kho infusion-detoxification yog ua.
Ua ntej kev txhaj tshuaj loj ntawm cov pejxeem, uas tau pib xyoo 1967, qhua pias tau hu ua "cov menyuam yaus tus kab mob plague." Nyob rau lub sijhawm muaj kev ntxhov siab, tus kab mob kis tau ua rau lub neej ntawm txhua tus menyuam mob thib plaub. Nrog rau kev tsim cov tshuaj tiv thaiv qis, kev sib kis ntawm tus kab mob tuag taus raug tso tseg, txawm li cas los xij, kev txhaj tshuaj tsis txo qhov kev pheej hmoo ntawm kev kis tus mob qhua pias mus rau xoom. Ua raws li cov hauv paus ntsiab lus ntawm kev noj zaub mov kom zoo thiab cov qauv kev huv thiab huv huv rau kev tu koj tus menyuam. Kev kho kom zoo ntawm thawj cov tsos mob ntawm tus mob qhua pias nyob rau hauv cov me nyuam yuav tso cai rau koj kom sai sai kov yeej tus kab mob insidious, rov qab tus me nyuam mus rau ib tug active, ua tiav lub neej!
